Publications
553 results found
Kirk E, Bourne T, 2009, Pregnancy of unknown location, Obstetrics, Gynaecology and Reproductive Medicine, Vol: 19, Pages: 80-83, ISSN: 1751-7214
All women with a positive pregnancy test who do not have a pregnancy visualised on transvaginal ultrasound, whether it is an intra-uterine pregnancy or an ectopic pregnancy, should be classified as having a 'pregnancy of unknown location' (PUL). Expectant management of haemodynamically stable asymptomatic women with a PUL has been shown to be safe. Serum human chorionic gonadotrophin levels, serum progesterone levels and mathematical models all have a role in the prediction of PUL outcome, which includes: a failing PUL, an intra-uterine pregnancy and an ectopic pregnancy. Surgical intervention in the form of diagnostic laparoscopy or uterine curettage does not have a role in the routine management of women with a PUL. This review article discusses the various aspects of management of women with a PUL. © 2008.
Ameye L, Valentin L, Testa AC, et al., 2009, A scoring system to differentiate malignant from benign masses in specific ultrasound-based subgroups of adnexal tumors, ULTRASOUND IN OBSTETRICS & GYNECOLOGY, Vol: 33, Pages: 92-101, ISSN: 0960-7692
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- Citations: 26
Bottomley C, Van BV, Mukri F, et al., 2009, The optimal timing of an ultrasound scan to assess the location and viability of an early pregnancy., HUM REPROD, Vol: 24 (8), Pages: 1811-1817
Betsas G, Van Den Bosch T, Deprest J, et al., 2008, The use of transvaginal ultrasonography to diagnose bladder carcinoma in women presenting with postmenopausal bleeding, ULTRASOUND IN OBSTETRICS & GYNECOLOGY, Vol: 32, Pages: 959-960, ISSN: 0960-7692
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- Citations: 8
Bora SA, Papageorghiou AT, Bottomley C, et al., 2008, Reliability of transvaginal ultrasonography at 7-9 weeks' gestation in the determination of chorionicity and amnionicity in twin pregnancies, ULTRASOUND IN OBSTETRICS & GYNECOLOGY, Vol: 32, Pages: 618-621, ISSN: 0960-7692
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- Citations: 26
Bignardi T, Condous G, Alhamdan D, et al., 2008, The hCG ratio can predict the ultimate viability of the intrauterine pregnancies of uncertain viability in the pregnancy of unknown location population, HUMAN REPRODUCTION, Vol: 23, Pages: 1964-1967, ISSN: 0268-1161
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- Citations: 21
Mukri F, Bourne T, Bottomley C, et al., 2008, Evidence of early first-trimester growth restriction in pregnancies that subsequently end in miscarriage, BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Vol: 115, Pages: 1273-1277, ISSN: 1470-0328
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- Citations: 55
Kirk E, Bourne T, 2008, Predicting outcomes in pregnancies of unknown location., Womens Health (Lond), Vol: 4, Pages: 491-499
A pregnancy of unknown location (PUL) is a descriptive term used to classify a woman when she has a positive pregnancy test but no intra- or extra-uterine pregnancy is visualized on transvaginal sonography. Expectant management has been shown to be safe for the majority of women with a PUL. Serum progesterone and human chorionic gonadotrophin levels as well as mathematical models play a role in predicting the final outcomes of PULs, which include intrauterine pregnancy, failing PUL and ectopic pregnancy. Other possible predictors of outcome have been studied, but currently no factor has been identified that combines accuracy with reproducibility and simplicity. This article discusses the various aspects of the management of women with PULs. Future work should be aimed at prospectively testing current models in order to predict the outcome of a PUL and minimizing follow-up.
Timmerman D, Testa AC, Bourne T, et al., 2008, Simple ultrasound-based rules for the diagnosis of ovarian cancer, ULTRASOUND IN OBSTETRICS & GYNECOLOGY, Vol: 31, Pages: 681-690, ISSN: 0960-7692
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- Citations: 355
Carbone RG, Terracini B, Marinaccio A, et al., 2008, Asbestos, pleural mesothelioma,and mortality in Italy., J Occup Environ Hyg, Vol: 5, Pages: D55-D56
Timmerman D, Bourne T, Amant F, et al., 2008, Pitfalls of CA-125 levels in the preoperative work-up of ovarian masses - Reply, JOURNAL OF CLINICAL ONCOLOGY, Vol: 26, Pages: 513-513, ISSN: 0732-183X
Alkatib M, Bourne TH, 2008, The role of ultrasound in investigating abnormal uterine bleeding, Modern Management of Abnormal Uterine Bleeding, Pages: 58-63, ISBN: 9780415454797
Investigation of abnormal uterine bleeding (AUB) is accountable for a significant proportion of the gynecologist’s outpatient workload. 1 As the management of AUB diversifies with new, sophisticated medical and surgical approaches, accurate and rapid diagnosis becomes desirable. Ideally, a diagnosis should be reached at the index visit with a specialist, thus requiring various diagnostic tools to aid this. Up to 60% of women will have no identifiable pathology to explain their AUB: to subject such women to a general anesthetic, hysteroscopy, and curettage carries a measure of financial and physical burden, as well as prolonging anxieties and delaying initiation of treatment. Many approaches have been suggested in an attempt to distinguish between women who warrant further operative intervention and women who could be initially managed with medical or conservative treatments.
Walker WJ, Haider Z, Bourne T, 2008, Pelvic ultrasound and interventional radiology, Ambulatory Gynaecology: A New Concept in the Treatment of Women, Pages: 106-119, ISBN: 9781904752349
Introduction Pelvic ultrasound scanning has a pivotal role in the provision of one-stop gynaecology services. It is particularly important for abnormal uterine bleeding (Chapter 4), infertility (Chapter 7) and early pregnancy complications (Chapter 8). It is also the primary diagnostic tool for the investigation of acute pelvic pain in the emergency gynaecology unit.1 A natural extension of the gynaecological examination, a transvaginal ultrasound scan (TVUS) should be used to confirm or exclude a diagnosis that is suspected on the basis of clinical findings. It is one of the least invasive diagnostic tools available. The transvaginal probe (5-7.5 MHz) produces a high-resolution image of the pelvic organs, providing reliable, reproducible information without the need for a full bladder. TVUS has had a major impact on gynaecological practice. It is the investigative tool of choice for triaging women with pelvic pain into appropriate treatment protocols, thus enabling the clinician to avoid surgery in some cases and select the best surgical approach in others. With the use of TVUS, common gynaecological pathology of the pelvic organs may be diagnosed with confidence. In the presence of a negative pregnancy test and a normal pelvic examination, a normal ultrasound scan gives reassurance that the risk of notable pelvic pathology is small. Provision of a TVUS facility as part of an outpatient or emergency assessment makes sense for both doctor and patient. The doctor can relate their scan findings directly to the history and examination that preceded the scan. For the woman it means a one-stop service rather than several visits for initial consultation, the scan and for any subsequent tests indicated by the scan.
Kirk E, Papageorghiou AT, Condous G, et al., 2008, A single transvaginal ultrasound examination as a test for ectopic pregnancy, BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Vol: 115, Pages: 121-122, ISSN: 1470-0328
Bora SA, Papageorghiou AT, Bottomley C, et al., 2008, Discrepancy in early pregnancy crown-rump length between twins as a predictor of spontaneous embryonic demise, BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Vol: 115, Pages: 124-124, ISSN: 1470-0328
Bottomley C, Van Belle V, Mukri F, et al., 2008, Ability to make a diagnosis at first early pregnancy ultrasound assessment according to gestational age, BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Vol: 115, Pages: 124-124, ISSN: 1470-0328
Bora SA, Papageorghiou AT, Bottomley C, et al., 2008, Can transvaginal ultrasound in early pregnancy reliably diagnose chorionicity and amnionicity in twin pregnancies?, BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Vol: 115, Pages: 120-120, ISSN: 1470-0328
Bottomley C, Kirk E, Mukri F, et al., 2008, Does discrepancy between expected and measured crown rump length in the early first trimester predict subsequent miscarriage?, BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Vol: 115, Pages: 122-122, ISSN: 1470-0328
Bottomley C, Van Belle V, Mukri F, et al., 2008, Development of a model to predict ability of ultrasound to make a diagnosis at first assessment in the unselected early pregnancy population, BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Vol: 115, Pages: 124-124, ISSN: 1470-0328
Van Calster B, Van Huffel S, Timmerman D, et al., 2008, Towards a clinical decision support system for pregnancies of unknown location, 21st IEEE International Symposium on Computer-Based Medical Systems, Publisher: IEEE COMPUTER SOC, Pages: 581-+, ISSN: 2372-9198
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- Citations: 2
Van Calster B, Van Belle V, Condous G, et al., 2008, Multi-class AUC metrics and weighted alternatives, International Joint Conference on Neural Networks, Publisher: IEEE, Pages: 1390-1396, ISSN: 2161-4393
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- Citations: 10
Kirk E, Bora S, Van Calster B, et al., 2008, <i>Chlamydia trachomatis</i> infection in patients attending an Early Pregnancy Unit:: Prevalence, symptoms, pregnancy location and viability, ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, Vol: 87, Pages: 601-607, ISSN: 0001-6349
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- Citations: 5
Kirk E, Daemen A, Papageorghiou AT, et al., 2008, Why are some ectopic pregnancies characterized as pregnancies of unknown location at the initial transvaginal ultrasound examination?, ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, Vol: 87, Pages: 1150-1154, ISSN: 0001-6349
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- Citations: 42
Kirk E, Papageorghiou AT, Condous G, et al., 2007, The diagnostic effectiveness of an initial transvaginal scan in detecting ectopic pregnancy, HUMAN REPRODUCTION, Vol: 22, Pages: 2824-2828, ISSN: 0268-1161
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- Citations: 102
Timmerman D, Van Calster B, Jurkovic D, et al., 2007, Inclusion of CA-125 does not improve mathematical models developed to distinguish between benign and malignant adnexal tumors, JOURNAL OF CLINICAL ONCOLOGY, Vol: 25, Pages: 4194-4200, ISSN: 0732-183X
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- Citations: 67
Condous G, Van Calster B, Kirk E, et al., 2007, Clinical information does not improve the performance of mathematical models in predicting the outcome of pregnancies of unknown location, FERTILITY AND STERILITY, Vol: 88, Pages: 572-580, ISSN: 0015-0282
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- Citations: 29
Kirk E, Papageorghiou AT, Tan L, et al., 2007, Positive predictive value of ultrasound for the diagnosis of molar pregnancy, BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Vol: 114, Pages: 1041-1041, ISSN: 1470-0328
Kirk E, Tan L, Condous G, et al., 2007, Selecting failing pregnancies in the pregnancy of unknown location (PUL) population to reduce follow-up, BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Vol: 114, Pages: 1037-1037, ISSN: 1470-0328
Bottomley C, Mukri F, Kirk E, et al., 2007, Anechoic free fluid in early intrauterine pregnancy does not predict outcome, 23rd Annual Meeting of the European-Society-of-Human-Reproduction-and-Embryology, Publisher: OXFORD UNIV PRESS, Pages: I83-I84, ISSN: 0268-1161
Kirk E, Tan L, Papageorghiou AT, et al., 2007, The performance of transvaginal sonography in the detection of ectopic pregnancy in the Early Pregnancy Unit, 23rd Annual Meeting of the European-Society-of-Human-Reproduction-and-Embryology, Publisher: OXFORD UNIV PRESS, Pages: I84-I84, ISSN: 0268-1161
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